Clostridioides difficile infection: Incidence and risk factors in a tertiary care facility in Riyadh, Saudi Arabia. Issue 7 (July 2020)

• Record Type: Journal Article
• Authors: Alzouby, Sally; Baig, Kamran; Alrabiah, Fahad; Shibl, Atef; Al-Nakhli, Daifallah; Senok, Abiola C.
• Is Part Of: Journal of infection and public health. Volume 13:Issue 7(2020)
• Page Start: 1012
• Page End: 1017
• Publication Date: 2020-07
• Subjects: Clostridioides difficile -- Epidemiology -- Infection control -- Saudi Arabia; Communicable diseases -- Periodicals; Public health -- Periodicals; Epidemiology -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Medical microbiology -- Periodicals; 614.4
• DOI: 10.1016/j.jiph.2019.10.014
• Languages: English
• ISSNs: 1876-0341

Abstract

Abstract: Background: Significant increase in rates of Clostridioides difficile associated diarrhea (CDI) has been reported globally but there remains a paucity of data from Saudi Arabia. Methodology: Prospective hospital-based surveillance for CDI using the Center for Disease Control (CDC) criteria was conducted from June to November 2015 in a tertiary healthcare facility in Riyadh, Saudi Arabia. Results: During the surveillance period, 106 episodes of CDI were identified among 59 patients in 137, 230 patient-days. The incidence of CDI was 3.5 per 10, 000 patient days. Of the 106 episodes, 58% (n = 61) were new cases, 12% (n = 13) were recurrent cases and 30% (n = 32) were duplicate cases. Majority of the new cases (n/N = 43/61; 70%) were healthcare onset, followed by community onset (21%) and 8% were community-onset healthcare associated. No statistically significant change in trend was observed during the surveillance period. The most prevalent CDI risk factor was use of proton pump inhibitor (PPI) (92%) followed by prolonged use of antibiotics (77%). Pareto-analysis indicated that controlling for PPI use, prolong and multiple antibiotic exposure and prolonged hospitalization results in 80% CDI reduction. Conclusion: The findings indicate a low incidence of CDI. Multicenter studies are needed to elucidate the burden to CDI in the country.